|
BIT DRILL 2.6MM 703702
|
Facility
|
OP
|
$1,125.00
|
|
| Hospital Charge Code |
270648598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.11 |
| Max. Negotiated Rate |
$562.50 |
| Rate for Payer: Aetna Commercial |
$427.50
|
| Rate for Payer: Aetna Medicare Advantage |
$337.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$286.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$286.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$286.88
|
| Rate for Payer: Cigna Commercial |
$562.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$337.50
|
| Rate for Payer: Oxford Commercial |
$225.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.81
|
|
|
BIT DRILL 2.7*100 MM
|
Facility
|
IP
|
$695.00
|
|
| Hospital Charge Code |
270648248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.25 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
|
|
BIT DRILL 2.7*100 MM
|
Facility
|
OP
|
$695.00
|
|
| Hospital Charge Code |
270648248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Aetna Commercial |
$264.10
|
| Rate for Payer: Aetna Medicare Advantage |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$177.22
|
| Rate for Payer: Cigna Commercial |
$347.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.50
|
| Rate for Payer: Oxford Commercial |
$139.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.42
|
|
|
BIT DRILL 2.7MM
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
270647952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$199.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.50
|
| Rate for Payer: Oxford Commercial |
$105.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$105.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.91
|
|
|
BIT DRILL 2.7MM
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
270647952
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
BIT DRILL 2.7mm X100mm D82710
|
Facility
|
IP
|
$190.00
|
|
| Hospital Charge Code |
270643574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
|
|
BIT DRILL 2.7mm X100mm D82710
|
Facility
|
OP
|
$190.00
|
|
| Hospital Charge Code |
270643574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$72.20
|
| Rate for Payer: Aetna Medicare Advantage |
$57.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.45
|
| Rate for Payer: Cigna Commercial |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.00
|
| Rate for Payer: Oxford Commercial |
$38.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.04
|
|
|
BIT DRILL 2.8MM
|
Facility
|
IP
|
$890.00
|
|
| Hospital Charge Code |
270641389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.50 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.50
|
|
|
BIT DRILL 2.8MM
|
Facility
|
OP
|
$660.00
|
|
| Hospital Charge Code |
270677147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$250.80
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$198.00
|
| Rate for Payer: Oxford Commercial |
$132.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.49
|
|
|
BIT DRILL 2.8MM
|
Facility
|
OP
|
$890.00
|
|
| Hospital Charge Code |
270641389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.45 |
| Max. Negotiated Rate |
$445.00 |
| Rate for Payer: Aetna Commercial |
$338.20
|
| Rate for Payer: Aetna Medicare Advantage |
$267.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.95
|
| Rate for Payer: Cigna Commercial |
$445.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$267.00
|
| Rate for Payer: Oxford Commercial |
$178.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$178.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.59
|
|
|
BIT DRILL 2.8MM
|
Facility
|
IP
|
$660.00
|
|
| Hospital Charge Code |
270677147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
BIT DRILL 2.8MM CALIBRATED
|
Facility
|
IP
|
$545.00
|
|
| Hospital Charge Code |
270646197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$81.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
|
|
BIT DRILL 2.8MM CALIBRATED
|
Facility
|
OP
|
$545.00
|
|
| Hospital Charge Code |
270646197
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.13 |
| Max. Negotiated Rate |
$272.50 |
| Rate for Payer: Aetna Commercial |
$207.10
|
| Rate for Payer: Aetna Medicare Advantage |
$163.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.97
|
| Rate for Payer: Cigna Commercial |
$272.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$163.50
|
| Rate for Payer: Oxford Commercial |
$109.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.44
|
|
|
BIT DRILL 2.8mm LONG DB28
|
Facility
|
OP
|
$396.85
|
|
| Hospital Charge Code |
270634970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$198.43 |
| Rate for Payer: Aetna Commercial |
$150.80
|
| Rate for Payer: Aetna Medicare Advantage |
$119.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.20
|
| Rate for Payer: Cigna Commercial |
$198.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.06
|
| Rate for Payer: Oxford Commercial |
$79.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$79.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.52
|
|
|
BIT DRILL 2.8mm LONG DB28
|
Facility
|
IP
|
$396.85
|
|
| Hospital Charge Code |
270634970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.53 |
| Max. Negotiated Rate |
$59.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.53
|
|
|
BIT DRILL 2.8mm SHORT MSDC28
|
Facility
|
OP
|
$345.00
|
|
| Hospital Charge Code |
270646196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Aetna Commercial |
$131.10
|
| Rate for Payer: Aetna Medicare Advantage |
$103.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.97
|
| Rate for Payer: Cigna Commercial |
$172.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.50
|
| Rate for Payer: Oxford Commercial |
$69.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$69.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.14
|
|
|
BIT DRILL 2.8mm SHORT MSDC28
|
Facility
|
IP
|
$345.00
|
|
| Hospital Charge Code |
270646196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.75 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.75
|
|
|
BIT DRILL 3.0MM
|
Facility
|
OP
|
$575.00
|
|
| Hospital Charge Code |
270664800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.86 |
| Max. Negotiated Rate |
$287.50 |
| Rate for Payer: Aetna Commercial |
$218.50
|
| Rate for Payer: Aetna Medicare Advantage |
$172.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$146.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$146.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$146.62
|
| Rate for Payer: Cigna Commercial |
$287.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.50
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.24
|
|
|
BIT DRILL 3.0MM
|
Facility
|
IP
|
$575.00
|
|
| Hospital Charge Code |
270664800
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
|
|
BIT DRILL 3.0MM
|
Facility
|
IP
|
$395.00
|
|
| Hospital Charge Code |
270677001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
BIT DRILL 3.0MM
|
Facility
|
OP
|
$395.00
|
|
| Hospital Charge Code |
270677001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$197.50 |
| Rate for Payer: Aetna Commercial |
$150.10
|
| Rate for Payer: Aetna Medicare Advantage |
$118.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.72
|
| Rate for Payer: Cigna Commercial |
$197.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.50
|
| Rate for Payer: Oxford Commercial |
$79.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$79.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.47
|
|
|
BIT DRILL 3.1mm X 204mm
|
Facility
|
OP
|
$597.40
|
|
| Hospital Charge Code |
270640120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna Commercial |
$227.01
|
| Rate for Payer: Aetna Medicare Advantage |
$179.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$152.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$152.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$152.34
|
| Rate for Payer: Cigna Commercial |
$298.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$179.22
|
| Rate for Payer: Oxford Commercial |
$119.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.83
|
|
|
BIT DRILL 3.1mm X 204mm
|
Facility
|
IP
|
$597.40
|
|
| Hospital Charge Code |
270640120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.61 |
| Max. Negotiated Rate |
$89.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.61
|
|
|
BIT DRILL 3.2mm
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270671871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.50
|
| Rate for Payer: Oxford Commercial |
$85.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.26
|
|
|
BIT DRILL 3.2mm
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270671871
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|